Radiology Resident Evaluation Form

Radiology Resident Evaluation Form
Use this form to evaluate a radiology resident’s clinical performance, professionalism, communication, and overall progress during a rotation.
Resident and Rotation Information
Resident Name
First NameMiddle NameLast Name
Training Level / PGY Year
Rotation / Site Name
Rotation Start Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Rotation End Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Evaluator Name
First NameMiddle NameLast Name
Evaluator Role / Relationship to Resident
Evaluation Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Performance Evaluation

Competency Rating Matrix

Rows	Needs Improvement	Meets Expectations	Exceeds Expectations
Radiology knowledge
Image interpretation accuracy
Case presentation quality
Procedural competence (if applicable)
Professionalism
Communication
Teamwork
Initiative
Reliability
Time management
Responsiveness to feedback

Select theme: